AGE Platform Europe

ABSTRACT In many countries, urban population ageing trends are a recognized policy issue that requires a multidisciplinary approach. Although some fields, such as urban planning, encounter challenges in incorporating age-friendliness, they are crucial in enhancing the quality of life and well-being of all urban inhabitants. Additionally, they should provide solutions on how cities can cater to the needs of a population that is living longer than ever before. To accomplish this, older people’s needs can be translated into multidomain indicators to be adopted when planning the cities. Using the World Health Organization’s age-friendly cities indicators framework as a basis, the objective of this research is to establish a new indicators framework for urban planners and policymakers. With this aim, within the H2020 URBANAGE project, various cities have followed a process to adapt the WHO´s general framework to their specific needs and interests, through research, iteration with the cities and co-creation methodologies with older people and civil servants. This process has resulted in the definition of an indicators framework, which aims to evaluate the age-friendliness of various neighbourhoods within a city. It also intends to inform the development of decision-support technologies to achieve age-friendly cities in the different cities involved.

Abstract Europe’s ageing demographics gave rise to the gold rush by entrepreneurs and innovators who started to investigate the market of solutions for older adults. Now joined by big players from the Information and Technology sector, the Silver Economy is a lion’s den where EU-funded research and innovation projects sometimes struggle to find a place. This chapter presents the dissemination, exploitation, and communication strategy developed for a virtual coach for healthy ageing designed within the “Horizon 2020” EU research and innovation programme, taking account of the latest macroeconomic forces at stake and aiming at the successful adoption and diffusion of this innovation in the healthcare market.

In recent years ageism has received increase international attention. In 2016 the UN dedicated the International Day of Older Persons to the fight against ageism and the World Heath Organization launched a campaign to combat ageism. This growing interest is also illustrated by the establishment of the UN Open-Ended Working Group on Ageing, and the related work on a UN convention on the rights of older persons, which, among other things, aims to provide better protection against discrimination. The ongoing discussions about a convention is accompanied by tensions between views assuming an older persons’ specific convention may reproduce age-related group differences and could perpetuate ageism, and those who argue that it will help reducing it. This article critically reflects on these discussions and some aspects of a potential convention that could provide basis for ageism critique. We refer to central sociological and legal arguments of the debate around ageism and age-based distinctions, which show clear intersections, e.g. the legal discussion one the justifiability of the general use of "age limits" and the socio-scientific debate on the relationship between age categorization and ageism. These intersections serve as central starting point for the question whether and to what extent age group differentiation and targeted human rights protection may (re-)produce ageism. Finally, we argue in favor of re-framing the debate about a convention on the rights of older persons towards a more universalist approach, which addresses possible age inequalities and critically reflects on the connection between chronological age and targeted human rights provisions.

Background: Palliative care is insufficiently integrated in the continuum of care for older people. It is unclear to what extent healthcare policy for older people includes elements of palliative care and thus supports its integration. Aim: (1) To develop a reference framework for identifying palliative care contents in policy documents; (2) to determine inclusion of palliative care in public policy documents on healthcare for older people in 13 rapidly ageing countries. Design: Directed documentary analysis of public policy documents (legislation, policies/strategies, guidelines, white papers) on healthcare for older people. Using existing literature, we developed a reference framework and data extraction form assessing 10 criteria of palliative care inclusion. Country experts identified documents and extracted data. Setting: Austria, Belgium, Canada, Czech Republic, England, Japan, Mexico, Netherlands, New Zealand, Singapore, Slovenia, South Korea, Spain. Results: Of 139 identified documents, 50 met inclusion criteria. The most frequently addressed palliative care elements were coordination and continuity of care (12 countries), communication and care planning, care for family, and ethical and legal aspects (11 countries). Documents in 10 countries explicitly mentioned palliative care, nine addressed symptom management, eight mentioned end-of-life care, and five referred to existing palliative care strategies (out of nine that had them). Conclusions: Health care policies for older people need revising to include reference to end-of-life care and dying and ensure linkage to existing national or regional palliative care strategies. The strong policy focus on care coordination and continuity in policies for older people is an opportunity window for palliative care advocacy.

Introduction:Integrated care programmes are increasingly being put in place to provide care to older people who live at home. Knowledge of how to further develop integrated care and how to transfer successful initiatives to other contexts is still limited. Therefore, a cross-European research project, called Sustainable Tailored Integrated Care for Older People in Europe (SUSTAIN), has been initiated with a twofold objective: 1. to collaborate with local stakeholders to support and monitor improvements to established integrated care initiatives for older people with multiple health and social care needs. Improvements focus on person-centredness, prevention orientation, safety and efficiency; 2. to make these improvements applicable and adaptable to other health and social care systems, and regions in Europe. This paper presents the overall structure and approach of the SUSTAIN project.Methods:SUSTAIN uses a multiple embedded case study design. In three phases, SUSTAIN partners: (i) conduct interviews and workshops with stakeholders from fourteen established integrated care initiatives to understand where they would prefer improvements to existing ways of working; (ii) collaborate with local stakeholders to support the design and implementation of improvement plans, evaluate implementation progress and outcomes per initiative, and carry out overarching analyses to compare the different initiatives, and; (iii) translate knowledge and experience to an online roadmap.Discussion:SUSTAIN aims to generate evidence on how to improve integrated care, and apply and transfer the knowledge gained to other health and social care systems, and regions. Lessons learned will be brought together in practical tools to inform and support policy-makers and decision-makers, as well as other stakeholders involved in integrated care, to manage and improve care for older people living at home.

In this paper, the user requirements, along with the methodology adopted towards their identification within the i-PROGNOSIS framework (www.i-prognosis.eu), are presented. The latter are placed within the concept of active and healthy ageing (AHA), focusing on the case of Parkinson's Disease (PD) patients' support. The bases for the user requirements identification were face-to-face sessions, focus groups and a large scale Web-survey. Towards the efficient user requirements identification and i-PROGNOSIS components development, exemplified usage scenarios and related business processes the stakeholders of i-PROGNOSIS can perform, are discussed. Overall, 122 functional and non-functional requirements were identified, serving as a basis for the spiral development model of i-PROGNOSIS, revealing the beneficial role of the users in designing solutions within the AHA concept.

Water scarcity and flooding associated to climate variability and poor water use efficiency affect the liveability of our cities and their water security in the long term. As advocated by the Integrated Water Management (IWM) model, a transition towards arrangements that, besides centralized water infrastructures, also include onsite and efficient organization of water flows is required. A Landscape Elements Water Management Strategy (LEWMS) has been outlined to immediately guide the exploration of potential source control solutions for the recurrent spatial elements of a given urban landscape (roofs, gardens, parks, etc.) and the result of their reiteration at the catchment level. In the LEWMS, spatial configurations, water flow patterns and stakeholder’s arrangements generated by the spread of different decentralized options are drawn up to allow their comparison. Tested in the Brussels-Capital Region (BCR), the analysed macro effects of micro-scale landscape-based practices are gaining the attention of the local institutions.

Abstract Despite significant regional diversity in household structures and the existence of community solidarity in Japan, caring for elderly dependent persons has traditionally been considered an exclusively family, and female, responsibility. However, as a result of socio‐demographic changes during the second half of the twentieth century, a public system of health care insurance was introduced in 2000. The objective of this development was to “socialize” family and female care activities. This article presents a critical analysis of Japan's health care insurance system and the context that gave rise to its introduction. An important issue is whether the system meets the needs of the elderly and their carers (family and non‐family). A further issue is whether the system can take account of regional diversity, diversity in household situations (above and beyond financial concerns), and societal values and beliefs. The article concludes by arguing that demographic ageing presents a societal requirement for the ongoing adjustment of behaviour patterns and living arrangements.

RésuméLa prise en charge des personnes âgées et à charge au Japon fut considérée comme une activité exclusive à la sphère familiale. Cette conception a prévalu en dépit de toutes les diversités régionales dans les structures familiales, d'une part, et l'existence jadis simultanée de solidarités extrafamiliales, d'autre part. L'évolution sociodémographique depuis le milieu du 20e siècle a amené non seulement les autorités politiques, mais aussi l'opinion publique, à la création d'une assurance publique de soins de santé. Instaurée en 2000, elle vise à«socialiser» ces activités à priori familiales et féminines. Cet article propose une analyse critique du système ainsi que du contexte dans lequel l'assurance a vu sa genèse. Le système répond‐il aux besoins des personnes âgées et de leurs entourages (familiaux et non familiaux)? Par ailleurs, tient‐il compte des diversités régionales, notamment en ce qui touche les situations des ménages, au‐delà des soucis financiers et des présuppositions sociétales? Le processus de vieillissement démographique connu par les sociétés industrialisées invite à revisiter leurs cheminements socio‐historiques, afin d'adapter continuellement les comportements et lieux de vie à des contextes socio‐économiques en importante évolution.